Supplement Myths

The key to keeping your mind sharp can't be found in a pill bottle

Popeye the Sailor Man, the beloved animated cartoon character who sang his signature little ditty about being “strong to the finish ’cause I eats me spinach,” evidently was on to something after all.

Scientists at Rush University and Tufts University’s Human Nutrition Research Center recently discovered that consuming a single serving of nutrient-rich, green leafy vegetables daily could help slow cognitive decline associated with aging.

The groundbreaking study, which was published in December 2017 in the highly respected and peer-reviewed journal Neurology, concluded that people with an average age of 81 who showed no existing signs of dementia and ate the greens were deemed to be a dozen years younger cognitively than others in the test group who didn’t dig in.

So if you want to stay sharp, fill up on fresh kale, spinach, swiss chard, collard greens and watercress. At the same time, you might want to steer clear of those over-the-counter (OTC), so-called brain health supplements and herbal remedies claiming to improve concentration, enhance short term memory, slow cognitive decline — or even avert dementia.

“I would love it if there were a magic pill. It would make our jobs much easier,” says Dr. Anthony Zizza, who is a professor of geriatrics at Harvard Medical School and the regional medical director for Landmark Health, which provides in-home care for seniors nationwide. “What I tell patients is that if you think you can take something, whether it’s a medication or an over-the-counter supplement, that will be the silver bullet, you can’t. It doesn’t exist. It does not exist. I wish it did.”

Rima Itani Al-Nimr, MS, RDN, LD, who is a clinical research dietician in the department of medicine at Dartmouth-Hitchcock Medical Center in Lebanon, says, “Currently, there is no good-quality or sufficient evidence to support the benefit of any dietary supplement marketed to prevent dementia or cognitive decline, and there is no compelling evidence to prescribe any supplement for this purpose.”

Nevertheless, the manufacturers of these products are taking in big bucks by preying upon seniors’ terrifying thoughts of memory loss.

One of the more prevalent products easily acquired over the counter almost anywhere is Prevagen. Priced at anywhere from $40 to $90 per bottle for a monthly supply, it claims in its ubiquitous national TV, radio and magazine ads, infomercials and social media campaigns to support seniors’ brain health, improve concentration and stop memory loss.

But the Federal Trade Commission and the New York attorney general have charged the product’s marketers with making false and unsubstantiated claims, and the status of the lawsuit remains pending. The consumer protection section of the website of the New Hampshire attorney general has a link to the information, which lists estimated gross revenues for Prevagen at roughly $165 million — the same amount the FTC wants, via fines, to return to people who bought the product.

Still, the product is only one among a multitude of this type of supplement being hawked over the counter, and ABC News reports that more than $140 million is generated in combined annual profits for the different companies making them.

As for the proverbial adding insult to injury, some supplements can do real damage to your health as well as to your wallet.

“It is important to note that in the United States, dietary supplements do not qualify as either a food or a drug and fall outside the umbrella of the FDA [the US Food and Drug Administration] for both manufacturer regulation and consumer protection,” says Itani Al-Nimr. “What is on the label is not necessarily what is in the bottle, and quality control is lacking. This can lead to potential serious issues with intake and safety. It is our job as healthcare professionals to ask our patients about the use of these supplements, and to advise them on the risks involved. At best, these supplements are a waste of money when it comes to preventing cognitive decline, and at worst, they may be unsafe.”

The experts say that it’s also important to recognize that there is no supplement, herbal remedy or vitamin available over the counter that can cure any of the other chronic conditions like cancer, cardiovascular disease, stroke, diabetes, arthritis and the rest.

Moreover, with the lack of regulation by the FDA, which is the government agency required to ensure that prescription drugs and over-the-counter pain medications and cold remedies are safe and perform as claimed before they can be sold, store shelves and websites are akin to the “wild, wild West.”
Even worse, when mixed with prescription medications, supplements can create a toxic cocktail.

“Just because they are over the counter does not mean that you can take them safely and be carefree,” says Dr. Samuel J. Goldman, who is a physician with Elliott Senior Health Primary Care in Manchester. He adds a great many of his patients spend a significant amount of money on supplements and vitamins. “It’s very important to talk to your doctor before you take anything.”

The operative word in that sage advice is doctor. It is not well-meaning friend, family member, neighbor, TV pitchman or stranger. So if you’re worried about experiencing those “senior moments” or simply wish to stay well and vital, what does the doctor order?

“Whole food nutrition is optimum. The best thing you can do for yourself is to eat a healthy, well-balanced diet, and the Mediterranean diet has proven time and time again to be very healthy for people,” says Zizza.

The clinical research dietician is in complete agreement. “A long-term intake of a Mediterranean-type meal plan with a focus on fruits, vegetables, whole grains, nuts, seeds, beans, fish, olive oil, fermented dairy such as yogurt and fiber is associated with reduced risk of cardiovascular problems over time. This in turn may possibly directly or indirectly reduce risk of dementia,” says Itani Al-Nimr. “Fish intake of two to three servings per week is associated with reduced cardiovascular risk, and a possible reduced risk of dementia. A higher food intake of plants, like flavonoid-containing berries, is associated with reduced inflammation and may slow cognitive decline.”

False Claims

If it sounds too good to be true, then it is, according to the conventional wisdom.

The experts on aging, cognitive decline and brain research say there is very little to no scientific evidence to support the claims made by a wide swath of so-called over-the-counter “brain health” supplements and herbal remedies. In fact, the Federal Trade Commission and the New York State attorney general have charged the manufacturer of one of the products, Prevagen, with making false claims as a memory booster and the legal action is pending.

Is there any recourse for Granite Staters who fear they’ve wasted their hard-earned money on any of these OTC supplements?

“Surprisingly, we do not get many complaints about these products,” says James Boffetti, New Hampshire’s senior assistant attorney general and the chief of the state’s Consumer Protection and Antitrust Bureau. “I’ve been here since 2009 and we have received very few calls where people would say there were [false] claims that were made, or I bought this because it was going to improve my memory, or whatever, and it doesn’t seem to do anything. If people feel they have bought these products that did not work as promised, they are encouraged to call my office.”

The NH Department of Justice’s Consumer Protection and Antitrust Bureau acts to protect consumers from unfair or deceptive trade practices in New Hampshire. Contact the office at doj.nh.gov/consumer.